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Slide Review Criteria

Parameters Reflexing Smear Review Slide review by qualified Laboratory Staff

Less than Greater Than
Review • Confirmation of differential percentages
WBC 3.5 x 10^³ 30.0 x 10^³ includes: • WBC and platelet estimates when
Hemoglobin 8.0 g/dL 20.0 g/dL
Hematocrit 22% 55%
needed- reflexing manual chamber
Platelet 100 x 10^³ 800 x 10^³ counts when appropriate
MCV 75 fL 105 fL • Full review of RBC morphology
MCH 22 pg 37 pg
MCHC 25 g/dL 36.5 g/dL • Comments for toxic changes, RBC
RBC 2.00 x 10^6 8.00 x 10^6 inclusions, abnormal lymphs, and other
MPV 1.5 15
Neutrophil # (IANC) 1.5 x 10^³ 18.0 x 10^³
significant findings
Lymphocyte # (ABLC) None 4.5 x 10^³ • If the differential percentages agree with
automated counts and no abnormal cells
Monocyte # (ABMN) None 2.0 x 10^³
Eosinophil # (ABEOS) None 2.0 x 10^³ are seen, the 10,000 cell automated
Basophil # (ABBAS) None 0.6 x 10^³ differential is reported with appropriate
Instrument Flags Variant Lymphs, Blasts,
immature neutrophils, nRBC’s, comments
abnormal platelets, Giant
Platelet, Potential interference
with measurements Laboratory staff will get Pathology
review for the following:
Patient Alerts Patients diagnosed with the
following conditions will have If any of the following are seen on slide • Blasts
alerts added for automatic
review, a manual differential is performed • New Abnormal Lymphocytes
smear review: Leukemia,
Sezary Cell and Hairy Cell • 2 or more immature neutrophils and Monocytes
Lymphoma, RBC agglutination,
• 2 or more nRBC’s • Schistocytes >3 per HPF
Platelet Clumping and other
conditions. • Disagreement with automated • Blood parasites
differential • Certain morphologic
• Greater than 50% Band Neutrophils abnormalities
If no parameters in the CBC with auto differential meet the
conditions above- the sample autoverifies • More than 3 activated Lymphocytes • Cells that are difficult to
• Abnormal cells (Blasts, Sezary , Hairy, identify or any concerns at all
Plasma, Burkitts cells, and more)

* Will have the comment “Peripheral smear reviewed visually” indicating completion of slide review or manual differential .
SM 07/06/15